A Case Series From a Multicentric Study: Can Artificial Intelligence (AI)-Enabled Chest X-Ray Assist in the Incidental Detection of Early-Stage Lung Cancers?

Lung cancer is the leading cause of cancer-related deaths worldwide. Early diagnosis is challenging, as patients are often asymptomatic. Low-dose computed tomography (LDCT) based screening has been shown to reduce mortality in high-risk individuals, but adoption is limited to a few countries. Chest X-ray is the most commonly used imaging modality in healthcare settings. Lung cancer can present as nodules on chest X-ray in the initial stages. Pulmonary nodules are often missed on routine chest X-rays. Artificial Intelligence (AI)-based chest X-ray software has shown promise in identifying nodules. We present a case series of five individuals in whom AI-enabled chest X-ray (qXR, Qure.ai, Mumbai, India) flagged suspicious pulmonary nodules on X-rays obtained for non-respiratory conditions. Computed tomography imaging and biopsy confirmed early-stage lung cancer in all five cases. Four individuals underwent curative surgical intervention with positive outcomes. One individual opted for chemotherapy alone. The use of AI software on routine chest X-rays identified suspicious nodules in asymptomatic individuals. The case series underscores the real-world impact of AI-enabled chest X-rays in the early detection of lung cancer.